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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 1995  |  Volume : 6  |  Issue : 2  |  Page : 154-156
Prevalence of Hepatitis C Virus Infection in Hemodialysis Patients in Sudan


1 Khartoum Kidney Dialysis Center, Sudan
2 Hepatitis Reference Lab Centers of Diseases Control (CDC) Clifton Road-Atlanta GA 30333, USA
3 Institute of Endemic Diseases, University of Khartoum, Sudan

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   Abstract 

To estimate the prevalence of positivity of hepatitis C virus (HCV) antibodies in the hemodialysis population in Sudan and the risk factors of this infection in them we studied 46 hemodialysis patients (34 males, 12 females) in the Khartoum Kidney Dialysis Center (KKDC) in December 1994. Also we studied 37 healthy staff members in that unit. The blood of both groups was screened for HCV antibodies using a second generation ELISA test and confirmed by two bead supplemental assays. In the patients group, 16 cases (34.9%) were confirmed seropositive for HCV. There was a history of jaundice in four them. The mean duration on dialysis was 3.28 years in the HCV seropositive group compared with 2.2 years in the HCV seronegative group (P < 0.05). The mean frequency of blood transfusion was 2.68 units of blood in the HCV seropositive group, while it was 3.16 units in the HCV seronegative group which was not significantly different. Only two patients had high liver enzymes in the HCV seropositive groups, while there were seven patients with high liver enzymes in the HCV seronegative group. There were two staff members (5.41%) with positive HCV antibodies, but none had a history of jaundice or elevated liver enzymes. Both staff members were not involved in the direct patients care. We conclude that the prevalence of HCV antibody positivity was high in the hemodialysis population in Sudan. Nosocomial transmission may be the factor of transmission since we found no correlation with the blood transfusions.

Keywords: Hepatitis C virus, Hemodialysis, Sudan.

How to cite this article:
Suliman SM, Fessaha S, El Sadig M, El-Hadi M B, Lambert S, Fields H, Ghalib HW. Prevalence of Hepatitis C Virus Infection in Hemodialysis Patients in Sudan. Saudi J Kidney Dis Transpl 1995;6:154-6

How to cite this URL:
Suliman SM, Fessaha S, El Sadig M, El-Hadi M B, Lambert S, Fields H, Ghalib HW. Prevalence of Hepatitis C Virus Infection in Hemodialysis Patients in Sudan. Saudi J Kidney Dis Transpl [serial online] 1995 [cited 2014 Jul 24];6:154-6. Available from: http://www.sjkdt.org/text.asp?1995/6/2/154/40858

   Introduction Top


Hepatitis C virus (HCV) infection is highly prevalent in hemodialysis population in both the developed and the developing countries [1],[2] . The prevalence of this infection is not known in the hemodialysis population in Sudan. In our study we tried to estimate the prevalence rate in this population.


   Materials and Methods Top


We studied 46 hemodialysis patients (34 males, 12 Females) in the Khartoum Kidney Dialysis Center (KKDC) in Khartoum the capital of Sudan, in December 1994. Also we studied 37 healthy staff members working in that unit. Blood of both groups were screened for HCV antibodies using a second generation enzyme linked immunosorbent assay (ELISA) test, and confirmed by two bead supplemental assays [3],[4] . The separated sera were sent to the Center of Disease Control (CDC) Atlanta GA, USA.

The etiology of end-stage renal disease (ESRD) in the 46 studied patients is shown in [Table - 1].


   Statistical analysis Top


We used the method of comparison of different data proportions where applicable, and the Student's "t" test to compare the mean values where applicable.


   Results Top


In the patients group 16 cases (34.9%) were confirmed positive for HCV antibodies. There was a history of jaundice in four of them (25%) compared with four patients (13.3%) in the negative HCV group, but the difference was not statistically significant. The mean duration on dialysis was 3.28 years in the HCV seropositive group compared with 2.2 years in the HCV seronegative group (P < 0.05). The mean frequency of blood transfusion was 2.68 units of blood in the HCV seropositive group, while it was 3.16 units in the HCV seronegative group, which was not significantly different. The liver enzymes were done for all the patients at the time of the study. Only two patients in the HCV seropositive group had high level liver enzymes versus seven patients in the HCV seronegative group, but the difference was not statistically significant. There were two staff members (5.41%) with HCV antibodies seropositivity without any history of Jaundice or blood transfusions. One of these staff members was a laboratory technician and the other was a mechanic. The liver functions were normal in one of them and elevated in the other. The latter used to drink alcohol.


   Discussion Top


The data presented in this study showed the prevalence of HCV antibodies in the hemodialysis patients. The risk factors related to HCV infection showed increased risk with the increased duration' on the hemodialysis, similar to what was reported by others [1],[2],[5] . The nosocomial spread of infection was suggested in our study group, since we found no significant correlation with any history of blood transfusion, which was different from what was reported before [6] . We did not re-use the dialysers or the tubing. Our staff members who were working directly with the patients were HCV seronegative, which suggested the horizontal transmission between patients, as was reported before [7] . We did not practice isolation as suggested by some other studies [8] . We conclude that HCV infection was prevalent in KKDC, but did not cause a considerable morbidity among the study patients. Blood transfusions might not be the only route for HCV infection. Another study is going on, in the same center, to estimate the incidence of HCV infection.


   Acknowledgment Top


We would like to thank Mr. Steve Lambert in the CDC laboratory, also we would like to thank Mrs. Lilian Emeel Yousif and Ali Kamal Ali for preparing the manuscript.

 
   References Top

1.Annual report of management of renal failure in Europe XXIV, 1993. Vienna 1994.  Back to cited text no. 1    
2.Padmanabhan R. Hepatitis C virus infection in hemodialysis patients in Saudi Arabia. Saudi J Kidney Dis Transplant 1994;5(2):157-8.  Back to cited text no. 2    
3.Jadoul M, Cornu C, Van Y Persela de Strihou C. Incidence and risk factors for hepatitis C seroconversion in hemodialysis: a prospective study. The UCL Collaboration group. Kidney Int 1993;44(6):1322-6.  Back to cited text no. 3    
4.Van der Poel CL, Cuypers HT, Reesink HW, et al. Confirmation of hepatitis C virus infection by new four-antigen recombinant immunoblot assay. Lancet 1991;337:317-9.  Back to cited text no. 4  [PUBMED]  
5.Huraib S, Al-Rasheed R, Aldrees A, Al-jefry M, Arif M, Faleh FA. High prevalence and risk factors for Hepatitis C in Saudi Arabia: A need for new strategies in dialysis practice (abstract). Saudi Kid Dis Transplant Bull 1993;4(S1):73.  Back to cited text no. 5    
6.Conway M, Catterall AP, Brown EA, et al. Prevalence of antibodies to hepatitis C in dialysis patients and transplant recipients with possible routes of transmission. Nephrol Dial Transplant 1992;7(12):1226-9.  Back to cited text no. 6    
7.Colombo P, Filiberti O, Porcu M, et al. Prevalence of hepatitis C infection in a hemodialysis unit. Nephron 1992;61(3):326-7.  Back to cited text no. 7    
8.Saeed AA, Suleiman M, Al-Khader A, Al-Rasheed AM, Rankin D, Mcomish F. PCR confirmation of hepatitis C viraemia among hemodialysis patients. The need for an isolation policy (abstract) Saudi Kidney Dis Transplant Bull 1993;4(S1);74.  Back to cited text no. 8    

Top
Correspondence Address:
Salma M Suliman
Consultant Nephrologist, Khartoum Kidney Dialysis Center, PO Box 102
Sudan
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PMID: 18583856

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    Abstract
    Introduction
    Materials and Me...
    Statistical analysis
    Results
    Discussion
    Acknowledgment
    References
    Article Tables
 

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